Individual
GREGORY K DEDINSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2326 18TH ST, STE 130, COLUMBUS, IN 47201-5359
(812) 376-0555
Mailing address
4403 N MERIDIAN ST, INDIANAPOLIS, IN 46208-3533
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
01036817A
IN
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
01036817A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000083890
ANTHEM
—
01
—
000000569472
ANTHEM
IN
05
—
100368780
—
IN
01
—
399009
WELLCARE
IN
01
—
4125843
AETNA
IN
01
—
CB8082
TRICARE
—
01
—
P01191761
RR MEDICARE PTAN
IN
Enumeration date
10/11/2006
Last updated
08/18/2016
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